Provider Demographics
NPI:1275661308
Name:ALFREDO SWEENY MD INC
Entity Type:Organization
Organization Name:ALFREDO SWEENY MD INC
Other - Org Name:SUNSET FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:SWEENY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-422-9939
Mailing Address - Street 1:5614 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-4711
Mailing Address - Country:US
Mailing Address - Phone:562-422-9939
Mailing Address - Fax:562-422-9940
Practice Address - Street 1:5614 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-4711
Practice Address - Country:US
Practice Address - Phone:562-422-9939
Practice Address - Fax:562-422-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25070261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A250701Medicaid
CAA25070OtherSTATE LICENSE NUMBER